Antibiotic Regimen for Lung Abscess

Abstract

To the Editor:Although the use of oral antibiotics in the therapy of nonspecific lung abscess seems justified on the basis of the data of Weiss and Cherniack,1Weiss W Cherniack NS Acute nonspecific lung abscess: A controlled study comparing orally and parenterally administered penicillin G.Chest. 1974; 66: 348-351Crossref PubMed Scopus (17) Google Scholar one must more closely examine the therapy itself. The primary treatment of a lung abscess is adequate drainage, hydration, and relief of obstruction. Thus, postural drainage, chest physiotherapy, and bronchoscopy for diagnostic cultures and relief of obstructing plugs provide the main tools of therapy regardless of the route of antibiotic medication and administration of the case.I recently reviewed 40 cases of nonspecific lung abscess at the University of California Hospitals, San Diego. All patients initially received penicillin or cephalosporin. Regardless of the antibiotic or route of administration, there was no difference in defervescence or fall in WBC.I suspect that any oral antibiotic (penicillin, tetracycline, lincomycin, 7-chlorolincomycin) would be as effective as parenteral antibiotic therapy just because antibiotics are not the mainstay of the therapeutic regimen. To the Editor: Although the use of oral antibiotics in the therapy of nonspecific lung abscess seems justified on the basis of the data of Weiss and Cherniack,1Weiss W Cherniack NS Acute nonspecific lung abscess: A controlled study comparing orally and parenterally administered penicillin G.Chest. 1974; 66: 348-351Crossref PubMed Scopus (17) Google Scholar one must more closely examine the therapy itself. The primary treatment of a lung abscess is adequate drainage, hydration, and relief of obstruction. Thus, postural drainage, chest physiotherapy, and bronchoscopy for diagnostic cultures and relief of obstructing plugs provide the main tools of therapy regardless of the route of antibiotic medication and administration of the case. I recently reviewed 40 cases of nonspecific lung abscess at the University of California Hospitals, San Diego. All patients initially received penicillin or cephalosporin. Regardless of the antibiotic or route of administration, there was no difference in defervescence or fall in WBC. I suspect that any oral antibiotic (penicillin, tetracycline, lincomycin, 7-chlorolincomycin) would be as effective as parenteral antibiotic therapy just because antibiotics are not the mainstay of the therapeutic regimen.